Impact of middle level eye care personnel on the delivery of eye care services in South-western Nigeria

Background: The objectives of the study were to review the training and assess the impact of middle level eye care personnel (community ophthalmic technician) with skills to complement the services of the ophthalmologist for efficient eye care system and fulfilling vision 2020 goals.Methods: The collaboration between 2010 and 2015 was reviewed with an institutional questionnaire for both Eye Foundation Centre and College of Health Technology in Ijebu, Nigeria: structure of 2 year training Programme and one year internship, community ophthalmic technicians (COT) as assistants to ophthalmologists, hierarchy/career options and challenges and ensuring clinical quality and their strength in the Eye Foundation Eye Health System were appraised.Results: From 2010 to 2015, a total of 72 COTs have graduated, 41(57%) of them employed by the Eye Foundation Hospital Group. Apart from this, 28 did their internship in 2015, 19 (68%) out of this at Eye Foundation establishments in southwestern and north central Nigeria. Others are employed by other government or nongovernmental agencies. From 2010 to 2015, outpatients’ visits have increased from 42,962 to 104,239 at its peak, surgical volume from 3,999 to 18,350 at the Eye Foundation Hospital Group. The COT programme has been accredited by International Joint Commission on Allied health personnel in Ophthalmology (IJCAHPO).Conclusions: COTs with skills are required in large numbers to complement the services of ophthalmologists for efficient eye health system. Their contribution is very important to meet the vision 2020 human resources objectives for Sub-Saharan Africa.

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Strengths and weaknesses of eye care services in sub-Saharan Africa: a meta-synthesis of eye health system assessments

BMC Health Services Research ◽

10.1186/s12913-020-05279-2 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Stevens Bechange ◽

Emma Jolley ◽

Bhavisha Virendrakumar ◽

Vladimir Pente ◽

Juliet Milgate ◽

...

Keyword(s):

Health System ◽

Sub Saharan Africa ◽

Eye Care ◽

Care Services ◽

Eye Health ◽

Sub Saharan

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Barriers and incentives for conducting research amongst the Ophthalmologists in Sub-Sahara Africa

10.1101/321679 ◽

2018 ◽

Author(s):

Kazim A Dhalla ◽

Micheal Guirguis

Keyword(s):

Health Care ◽

Sub Saharan Africa ◽

Vision 2020 ◽

Eye Care ◽

Research Knowledge ◽

Study Region ◽

Eye Health ◽

Conducting Research ◽

The Right ◽

Preventable Blindness

AbstractBackgroundResearch is a critical component amongst the strategies to improve health outcomes of any country. The role of research assumes greater importance in Africa as it carries a larger share of global burden of diseases, blindness and low vision. “Vision 2020- the Right to Sight” is a WHO-IAPB collaborated initiative aiming to eliminate preventable blindness by the year 2020. High quality research in eye care is imperative for the initiative to succeed, however, there is a dearth of research in eye care in sub Saharan Africa in general and specifically in the Eastern, Central and Southern African (ECSA) region. Identifying the barriers that hamper research in this region is an important step towards elimination of preventable blindness.MethodsA structured questionnaire using the SurveyMonkey program was sent to ophthalmologists in the ECSA region and South Africa through their respective regional professional bodies. Data was analyzed using the SPSS program version.ResultsLack of funding, inadequate time and poor research knowledge were the main research barriers while ability to improve eye health care through research was the main incentive for conducting research.ConclusionThe barriers mainly center on financial, human and administrative infrastructure and resources. In spite of the barriers, ophthalmologists in the study region are enthusiastic in research aiming to increase evidence based knowledge to improve eye health care in line with the goals of “Vision 2020- the Right to Sight” initiative.

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Perception of Professionals towards Effectiveness of Human Resource Information System

Journal of Strategic Human Resource Management ◽

10.21863/jshrm/2015.4.3.017 ◽

2015 ◽

Vol 4 (3) ◽

Author(s):

Bharti Motwani

Keyword(s):

Information System ◽

Human Resource ◽

Training Programme ◽

Middle Level ◽

Human Beings ◽

Human Resource Information System ◽

Resource Information ◽

Future Challenges ◽

Operational Decision Making ◽

The Impact

Organizations are facing stiff market and other external pulls and pushes, thus HR will become vital source for managing future challenges. HRIS is an information system that makes use of computers to monitor, control, and influence the movement of human beings from the time they indicate their intention to join an organization till the time they separate from it. The purpose of the HRIS is to provide service, in the form of accurate and timely information, to the clients of the system. As there are a variety of potential users of HR information, it may be used for strategic, tactical, and operational decision making (e.g., to plan for needed professionals in a merger), to avoid litigation (e.g., to identify discrimination problems in hiring), to evaluate programmes, policies, or practices (e.g., to evaluate the effectiveness of a training programme), and/or to support daily operations (e.g., to help managers monitor time and attendance of their professionals). However, in order to maximize HRIS success, researchers and practitioners have to know more about its underlying drivers. The study is undertaken looking to the importance of HRIS in the organizations. The paper identifies the factors of HRIS as perceived by professional users. This study is also an attempt to study the impact of designation on identified factors of Human Resource Information System (HRIS). The results of this research will increase researchers comprehension on difference in factors that influence effectiveness of senior and middle-level professionals.

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The Technical Feasibility of Integrating Primary Eye Care Into Primary Health Care Systems in Nigeria: Protocol for a Mixed Methods Cross-Sectional Study (Preprint)

10.2196/preprints.17263 ◽

2019 ◽

Author(s):

Ada Aghaji ◽

Helen Burchett ◽

Shaffa Hameed ◽

Jayne Webster ◽

Clare Gilbert

Keyword(s):

Health Care ◽

Primary Health Care ◽

Health System ◽

Assessment Tools ◽

Sub Saharan Africa ◽

Eye Care ◽

Technical Feasibility ◽

Primary Eye Care ◽

Primary Health ◽

Sub Saharan

BACKGROUND Approximately 90% of the 253 million blind or visually impaired people worldwide live in low- and middle-income countries. Lack of access to eye care is why most people remain or become blind. The World Health Organization Regional Office for Africa (WHO-AFRO) recently launched a primary eye care (PEC) package for sub-Saharan Africa—the WHO-AFRO PEC package—for integration into the health system at the primary health care (PHC) level. This has the potential to increase access to eye care, but feasibility studies are needed to determine the extent to which the health system has the capacity to deliver the package in PHC facilities. OBJECTIVE Our objective is to assess the technical feasibility of integrating the WHO-AFRO PEC package in PHC facilities in Nigeria. METHODS This study has several components, which include (1) a literature review of PEC in sub-Saharan Africa, (2) a Delphi exercise to reach consensus among experts regarding the technical complexity of the WHO-AFRO PEC package and the capacities needed to deliver it in PHC facilities, (3) development of PEC technical capacity assessment tools, and (4) data collection, including facility surveys and semistructured interviews with PHC staff and their supervisors and village health workers to determine the capacities available to deliver PEC in PHC facilities. Analysis will identify opportunities and the capacity gaps that need to be addressed to deliver PEC. RESULTS Consensus was reached among experts regarding the technical complexity of the WHO-AFRO PEC package and the capacities needed to deliver it as part of PHC. Quantitative tools (ie, structured questionnaires, in-depth interviews, and observation checklists) and topic guides based on agreed-upon technical capacities have been developed and relevant stakeholders have been identified. Surveys in 48 PHC facilities and interviews with health professionals and supervisors have been undertaken. Capacity gaps are being analyzed. CONCLUSIONS This study will determine the capacity of PHC centers to deliver the WHO-AFRO PEC package as an integral part of the health system in Nigeria, with identification of capacity gaps. Although capacity assessments have to be context specific, the tools and findings will assist policy makers and health planners in Nigeria and similar settings, who are considering implementing the package, in making informed choices. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/17263

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Evaluating Eye Health Care Services Progress Towards VISION 2020 Goals in Gurage Zone, Ethiopia.

10.21203/rs.3.rs-900364/v1 ◽

2021 ◽

Author(s):

Tiliksew Teshome ◽

Omar Salamanca ◽

Alana Calise ◽

Jibat Gemida Soboka

Keyword(s):

Health Care ◽

Service Delivery ◽

Human Resources ◽

Catchment Area ◽

Care Center ◽

Health Care Facilities ◽

Vision 2020 ◽

Eye Care ◽

Primary Eye Care ◽

Eye Health

Abstract Background Ethiopia signed the VISION 2020 Global Declaration and launched its eye health program in 2002. Since then, there has been limited systematic and comprehensive evaluation of the progress towards VISION 2020 goals in Ethiopia.Purpose To evaluate Gurage Zone progress towards VISION 2020 targets and process indicators.Method An institutional-based cross-sectional study was conducted among all public and private eye health care facilities in the Gurage Zone within the Southern Nations, Nationalities, and People Region of Ethiopia. The evaluation protocol was adopted from the VISION 2020 situational analysis data collection tool. We used this structure to evaluate progress in terms of human resources, infrastructure, and service delivery at the Zonal Health Office and facility level.Result At the time of the study, the Gurage Zone had a 1.7 million catchment area population. There was a total of five eye care centers, of which one was established by a Non-Governmental Organization. Three of these facilities were secondary eye care centers with an operating theater and two of them were primary eye care centers. At the zonal level, there is no survey data available on the prevalence of blindness. There was no systemic evaluation of VISION 2020 process indicators. The budget allocation specific to eye health care was less than 0.7% of the total budget of the office. The human resources for eye health in the catchment area were: one ophthalmologist, two cataract surgeons, five optometrists, and 12 ophthalmic nurses, which is below the VISION 2020 targets for human resources for eye health. In terms of equipment, neither primary eye care center had a slit lamp biomicroscope, and two of the three secondary eye care centers did not have intraocular pressure (IOP) measuring equipment. Only one secondary eye care center was providing glaucoma surgical services, and no center provided either emergency or elective pediatric surgery. The cataract surgical rate (CSR) determined by the study was 1967.ConclusionGurage Zone had not achieved VISION 2020 goals in terms of critical human resources and service delivery. We recommend that the Zonal Health Office carries out a focused and baseline evaluation of eye health care service achievements.

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Gender equity in eye health of Nepal: A hospital-based study

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v4i2.6544 ◽

2012 ◽

Vol 4 (2) ◽

pp. 277-281 ◽

Cited By ~ 1

Author(s):

M K Shrestha ◽

H Chan ◽

R Gurung

Keyword(s):

Gender Equity ◽

Clinical Care ◽

Hospital Setting ◽

Surgical Care ◽

Urban Hospital ◽

Eye Care ◽

Care Services ◽

Eye Health ◽

Clinical Records ◽

The Impact

Introduction: There is a lack of literature examining the impact of gender on access to eye care in developing countries. Objective: To assess the differences in access to eye care between females and males, in the urban hospital setting and in rural outreach clinics. Materials and methods: A retrospective study was designed to review the patients who sought eye care at a tertiary level eye care institute and its rural outreach clinics from 2006 to 2009 in Nepal. Data were retrieved from clinical records. Results: In the hospital, females accounted for 50.8% of patients receiving outpatient care and 48.3% of patients receiving surgical care. In rural outreach clinics, females accounted for 56.1% of clinic patients and 51.5% of patients undergoing surgery. Fewer girls than boys aged 0-14 years (44.3%) sought clinical care at the hospital. Conclusion: Females account for approximately half of the hospital eye care services in Nepal. More females seek care at rural outreach clinics than at the urban hospital. However, given the female burden of disease in Nepal, there is still much improvement to be made in this area of care.DOI: http://dx.doi.org/10.3126/nepjoph.v4i2.6544 Nepal J Ophthalmol 2012; 4 (2): 277-281

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Trends and implications for achieving VISION 2020 human resources for eye health targets in 16 countries of sub-Saharan Africa by the year 2020

Human Resources for Health ◽

10.1186/1478-4491-12-45 ◽

2014 ◽

Vol 12 (1) ◽

Cited By ~ 21

Author(s):

Jennifer J Palmer ◽

Farai Chinanayi ◽

Alice Gilbert ◽

Devan Pillay ◽

Samantha Fox ◽

...

Keyword(s):

Human Resources ◽

Sub Saharan Africa ◽

Vision 2020 ◽

Health Targets ◽

Eye Health ◽

Sub Saharan

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The Technical Feasibility of Integrating Primary Eye Care Into Primary Health Care Systems in Nigeria: Protocol for a Mixed Methods Cross-Sectional Study

JMIR Research Protocols ◽

10.2196/17263 ◽

2020 ◽

Vol 9 (10) ◽

pp. e17263

Author(s):

Ada Aghaji ◽

Helen Burchett ◽

Shaffa Hameed ◽

Jayne Webster ◽

Clare Gilbert

Keyword(s):

Health Care ◽

Primary Health Care ◽

Health System ◽

Assessment Tools ◽

Sub Saharan Africa ◽

Eye Care ◽

Technical Feasibility ◽

Primary Eye Care ◽

Primary Health ◽

Sub Saharan

Background Approximately 90% of the 253 million blind or visually impaired people worldwide live in low- and middle-income countries. Lack of access to eye care is why most people remain or become blind. The World Health Organization Regional Office for Africa (WHO-AFRO) recently launched a primary eye care (PEC) package for sub-Saharan Africa—the WHO-AFRO PEC package—for integration into the health system at the primary health care (PHC) level. This has the potential to increase access to eye care, but feasibility studies are needed to determine the extent to which the health system has the capacity to deliver the package in PHC facilities. Objective Our objective is to assess the technical feasibility of integrating the WHO-AFRO PEC package in PHC facilities in Nigeria. Methods This study has several components, which include (1) a literature review of PEC in sub-Saharan Africa, (2) a Delphi exercise to reach consensus among experts regarding the technical complexity of the WHO-AFRO PEC package and the capacities needed to deliver it in PHC facilities, (3) development of PEC technical capacity assessment tools, and (4) data collection, including facility surveys and semistructured interviews with PHC staff and their supervisors and village health workers to determine the capacities available to deliver PEC in PHC facilities. Analysis will identify opportunities and the capacity gaps that need to be addressed to deliver PEC. Results Consensus was reached among experts regarding the technical complexity of the WHO-AFRO PEC package and the capacities needed to deliver it as part of PHC. Quantitative tools (ie, structured questionnaires, in-depth interviews, and observation checklists) and topic guides based on agreed-upon technical capacities have been developed and relevant stakeholders have been identified. Surveys in 48 PHC facilities and interviews with health professionals and supervisors have been undertaken. Capacity gaps are being analyzed. Conclusions This study will determine the capacity of PHC centers to deliver the WHO-AFRO PEC package as an integral part of the health system in Nigeria, with identification of capacity gaps. Although capacity assessments have to be context specific, the tools and findings will assist policy makers and health planners in Nigeria and similar settings, who are considering implementing the package, in making informed choices. International Registered Report Identifier (IRRID) DERR1-10.2196/17263

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Peek Community Eye Health - mHealth system to increase access and efficiency of eye health services in Trans Nzoia County, Kenya: study protocol for a cluster randomised controlled trial.

10.21203/rs.2.327/v1 ◽

2019 ◽

Author(s):

Hillary Rono ◽

Andrew Bastawrous ◽

David Macleod ◽

Emmanuel Wanjala ◽

Stephene Gichuhi ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Health System ◽

Controlled Trial ◽

Cluster Randomised Controlled Trial ◽

Eye Care ◽

Community Screening ◽

Eye Health ◽

Cluster Randomised ◽

Eye Problems ◽

Randomised Controlled

Abstract Background: Globally eye care provision is currently insufficient to meet the requirement for eye care services. Lack of access and awareness are key barriers to specialist services, in addition, specialist services are over utilised by people with conditions that could be managed in the community or primary care. In combination, these lead to a large unmet need for eye health provision. We have developed a validated smart phone-based screening algorithm (Peek Community Screening App). The application (app) is part of the Peek Community Eye Health system (Peek CEH) that enables Community Volunteer (CVs) to make referral decisions about patients with eye problems. It generates referrals, automated short messages service (SMS) notifications to patients and carers and has a program dashboard for visualizing service delivery. We hypothesize that a greater proportion of people with eye problems will be identified using the Peek CEH system and that there will be increased uptake of referrals, compared to those identified and referred using the current community screening approaches. Methods: A single masked, cluster-randomised controlled trial. The unit of randomisation will be the “community units”, defined as a dispensary or health centres with its catchment population. The community units will be allocated to receive either the intervention (Peek CEH system) or the current care (periodic health centre-based outreach clinics with onward referral for further treatment). In both arms, a triage clinic will be held at the link health facility four weeks from sensitization, where attendance will be ascertained. During triage participants will be assessed and treated, and if necessary referred onwards to Kitale eye unit. Discussion: We aim to evaluate a M-health system (Peek CEH) geared towards reducing avoidable blindness through early identification and improved adherence to referral for those with eye problems and reducing demand at secondary care for conditions that can be managed effectively at primary care level. Trial registration: The Pan African Clinical Trials Registry (PACTR), 201807329096632. Registered 8th june 2018, https://pactr.samrc.ac.za. Keywords: Eye problems, Visual Impairement, Access, Primary eye care , Community Eye Health system, Community volunteres, Peek community screening app., cluster randomised controlled trial.

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